Student Enrolment Form - kenningtonps.vic.edu.au · Web viewGroup ASenior management in large...

DEPARTMENT OF EDUCATION AND TRAINING ENROLMENT FORM - INFORMATION for PARENTS, GUARDIANS and CARERS

(including privacy collection notice)

The Enrolment Form asks you for personal and health information about your child and your family. This information is collected to enable our school to educate your child and support your child’s social and emotional wellbeing and health. Our school is also required by legislation, such as the Education and Training Reform Act 2006, to collect some of this information.

Our school relies on you to provide health information about any medical condition or disability that your child has, medication your child may take while at school, any known allergies and contact details of your child’s doctor. If you do not provide all relevant health information, this may put your child’s health at risk.

Our school requires current, relevant information about all parents, guardians and carers so that we can take account of family arrangements. Please provide our school with copies of all current parenting plans AND court orders regarding parenting arrangements. Please provide copies of court orders or plans when they change. If you wish to discuss any matters regarding family arrangements in confidence, please contact the principal.

PROTECTING YOUR PRIVACY AND SHARING INFORMATION The information about your child and family collected through this Enrolment Form will only be shared with school staff who need to know to enable our school to educate or support your child, or to fulfil legal obligations including duty of care, anti-discrimination law and occupational health and safety law. The information collected will not be disclosed beyond the Department of Education and Training without your consent, unless such disclosure is lawful. For more about information-sharing and privacy, see our school’s privacy policy at: Kennington Primary School

OUR SCHOOL’S USE OF ONLINE TOOLS (INCLUDING APPS AND OTHER SOFTWARE) TO COLLECT AND MANAGE INFORMATION Our school may use online tools, such as apps and other software, to collect and manage information about your child. When our school uses these online tools, we do our best to ensure that your child’s information is secure. These online tools enable our school to efficiently and effectively manage important information about your child and also to communicate with you. If you have any concerns about the use of these online tools, please contact us.

EMERGENCY CONTACTSEmergency contacts are those people you nominate for the school to contact during an emergency. Please ensure your nominated emergency contact agrees to you providing their contact details to our school and that they have read the paragraph above. It is important that you inform them that their contact details may be disclosed beyond the Department if lawful.

STUDENT BACKGROUND INFORMATIONThe enrolment form requests information about country of birth, aboriginality, language spoken at home and parent occupation. This information enables the Department to allocate appropriate resources to our school. The Department also uses this information to plan for future educational needs in Victoria and shares some information with the Commonwealth government to monitor, plan and allocate resources.

IMMUNISATION STATUSYour child’s immunisation status assists our school to manage health risks for children. The Department may also provide this information to the Department of Health and Human Services to assess immunisation rates in Victoria, but not in a way which identifies you.

VISA STATUSOur school also requires this information to process your child’s enrolment.

UPDATING YOUR CHILD’S PERSONAL AND HEALTH INFORMATIONPlease inform our school if, and when, there are any updates to any of the personal or health information you provide on the Enrolment Form.

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ACCESSING YOUR CHILD’S RECORDSOur school provides ordinary school communications and school reports to students and parents, guardians and carers who have legal decision-making responsibility for the student. Requests for any other type of student records may be made through a Freedom of Information (FOI) application. Please contact our school and we can advise you how to do this.

STUDENT TRANSFERS BETWEEN VICTORIAN GOVERNMENT SCHOOLSWhen our students transfer to another Victorian government school, our school will transfer the student’s personal and health information to that next school. This may include copies of student’s school records, including any health information. Transferring this information assist the next school to provide the best possible education and support to students.

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PARENTAL OCCUPATION GROUP CODESThe codes outlined below are to be used when providing family occupation details for enrolled students. This information is used for

determining funding allocations to schools.

GROUP A Senior management in large business organisation, government administration and defence, and qualified professional s

Senior Executive / Manager / Department Head in industry, commerce, media or other large organisationPublic Service Manager (Section head or above), regional director, health / education / police / fire services administratorOther administrator (school principal, faculty head / dean, library / museum / gallery director, research facility director)Defence Forces Commissioned OfficerProfessionals - generally have degree or higher qualifications and experience in applying this knowledge to design, develop or

operate complex systems; identify, treat and advise on problems; and teach others: Health, Education, Law, Social Welfare, Engineering, Science, Computing professional Business (management consultant, business analyst, accountant, auditor, policy analyst, actuary, valuer) Air/sea transport (aircraft / ship’s captain / officer / pilot, flight officer, flying instructor, air traffic controller)

GROUP B Other business managers, arts/media/sportspersons and associate professionals

Owner / Manager of farm, construction, import/export, wholesale, manufacturing, transport, real estate businessSpecialist Manager (finance / engineering / production / personnel / industrial relations / sales / marketing)Financial Services Manager (bank branch manager, finance / investment / insurance broker, credit / loans officer)Retail sales / Services manager (shop, petrol station, restaurant, club, hotel/motel, cinema, theatre, agency)Arts / Media / Sports (musician, actor, dancer, painter, potter, sculptor, journalist, author, media presenter, photographer, designer,

illustrator, proof reader, sportsman/woman, coach, trainer, sports official)Associate Professionals - generally have diploma / technical qualifications and support managers and professionals:

Health, Education, Law, Social Welfare, Engineering, Science, Computing technician / associate professional Business / administration (recruitment / employment / industrial relations / training officer, marketing / advertising specialist,

market research analyst, technical sales representative, retail buyer, office / project manager) Defence Forces senior Non-Commissioned Officer

GROUP C Tradesmen/women, clerks and skilled office, sales and service staff

Tradesmen/women generally have completed a 4 year Trade Certificate, usually by apprenticeship. All tradesmen/women are included in this group

Clerks (bookkeeper, bank / PO clerk, statistical / actuarial clerk, accounting / claims / audit clerk, payroll clerk, recording / registry / filing clerk, betting clerk, stores / inventory clerk, purchasing / order clerk, freight / transport / shipping clerk, bond clerk, customs agent, customer services clerk, admissions clerk)

Skilled office, sales and service staff: Office (secretary, personal assistant, desktop publishing operator, switchboard operator) Sales (company sales representative, auctioneer, insurance agent/assessor/loss adjuster, market researcher) Service (aged / disabled / refuge / child care worker, nanny, meter reader, parking inspector, postal worker, courier, travel

agent, tour guide, flight attendant, fitness instructor, casino dealer/supervisor)

GROUP D Machine operators, hospitality staff, assistants, labourers and related workers

Drivers, mobile plant, production / processing machinery and other machinery operatorsHospitality staff (hotel service supervisor, receptionist, waiter, bar attendant, kitchen hand, porter, housekeeper)Office assistants, sales assistants and other assistants:

Office (typist, word processing / data entry / business machine operator, receptionist, office assistant) Sales (sales assistant, motor vehicle / caravan / parts salesperson, checkout operator, cashier, bus / train conductor, ticket

seller, service station attendant, car rental desk staff, street vendor, telemarketer, shelf stacker) Assistant / aide (trades’ assistant, school / teacher's aide, dental assistant, veterinary nurse, nursing assistant, museum /

gallery attendant, usher, home helper, salon assistant, animal attendant)Labourers and related workers

Defence Forces - ranks below senior NCO not included above Agriculture, horticulture, forestry, fishing, mining worker (farm overseer, shearer, wool / hide classer, farm hand, horse

trainer, nurseryman, greenkeeper, gardener, tree surgeon, forestry/ logging worker, miner, seafarer / fishing hand) Other worker (labourer, factory hand, storeman, guard, cleaner, caretaker, laundry worker, trolley collector, car park

attendant, crossing supervisor

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KENNINGTON PRIMARY SCHOOL

STUDENT ENROLMENT INFORMATION 2021 Computer Generated Student ID:

OFFICE USE ONLY:Child’s Name and Birth Date proof sighted (tick) Yes No Enrolment Date:

Year Level

Home Group House Campus

Immunisation Certificate received?: (tick) Complete Not sighted

Has a Transition Statement been provided (either by the Early Childhood Educator or parents)? (tick)For prep students only

Yes No Pending

STUDENT DETAILSPERSONAL DETAILS OF STUDENT

Surname: FORMTEXT Title: (Miss Ms Mr) Choose an item.

First Given Name: FORMTEXT

Second Given Name: FORMTEXT

Preferred Name (if applicable): FORMTEXT

Sex (tick): ☐ Male ☐ Female Birth Date: (dd-mm-yyyy) Click or tap to enter a date.

Student Mobile Number:

PRIMARY FAMILY HOME ADDRESS:No. & Street details

Suburb: FORMTEXT

State: Postcode:

Telephone Number Silent Number: (tick) ☐ Yes ☐ No

Mobile Number: Fax Number:

FAMILY DETAILS List any other family members who are attending or have attended this school:

FORMTEXT

This question is asked as a requirement of the Commonwealth Government. All schools across Australia are required to collect the same information.

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PRIMARY FAMILY DETAILSNOTE: The ‘PRIMARY’ Family is: “the family or parent the student mostly lives with”.

ADULT A DETAILS (PRIMARY CARER):

Sex (tick): ☐ Male ☐ Female

Title: (Ms, Mrs, Mr, Dr etc)

Legal Surname: FORMTEXT

Legal First Name: FORMTEXT

What is Adult A’s occupation? FORMTEXT

Who is Adult A’s employer? FORMTEXT

In which country was Adult A born?

☐ Australia ☐ Other (please specify):

Does Adult A speak a language other than English at home? (If more than one language is spoken at home, indicate the one that is spoken most often.) (tick)☐ No, English only☐ Yes (please specify):

Please indicate any additional languages spoken by Adult A:

Is an interpreter required? (tick) ☐ Yes ☐ No

What is the highest year of primary or secondary school Adult A has completed? (tick one) (For persons who have never attended school, mark ‘Year 9 or equivalent or below’.)☐ Year 12 or equivalent☐ Year 11 or equivalent☐ Year 10 or equivalent☐ Year 9 or equivalent or below

What is the level of the highest qualification the Adult A has completed? (tick one)☐ Bachelor degree or above☐ Advanced diploma / Diploma☐ Certificate I to IV (including trade certificate)☐ No non-school qualification

What is the occupation group of Adult A? Please select the appropriate parental occupation group from the attached list. If the person is not currently in paid work but has had a job in

the last 12 months, or has retired in the last 12 months, please use their last occupation to select from the attached occupation group list.

If the person has not been in paid work for the last 12 months, mark ‘N’.

ADULT B DETAILS:

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Title: (Ms, Mrs, Mr, Dr etc)



What is Adult B’s occupation? FORMTEXT

Who is Adult B’s employer? FORMTEXT

In which country was Adult B born?


Does Adult B speak a language other than English at home? (If more than one language is spoken at home, indicate the one that is spoken most often.) (tick)☐ No, English only☐ Yes (please specify):

Please indicate any additional languages spoken by Adult B:


What is the highest year of primary or secondary school Adult B has completed? (tick one) (For persons who have never attended school, mark ‘Year 9 or equivalent or below’.)☐ Year 12 or equivalent☐ Year 11 or equivalent☐ Year 10 or equivalent☐ Year 9 or equivalent or below

What is the level of the highest qualification the Adult B has completed? (tick one)

☐ Bachelor degree or above☐ Advanced diploma / Diploma☐ Certificate I to IV (including trade certificate)☐ No non-school qualification

What is the occupation group of Adult B? Please select the appropriate parental occupation group from the attached list. If the person is not currently in paid work but has had a job in



These questions are asked as a requirement of the Commonwealth Government. All schools across Australia are required to collect the same information

Main language spoken at home: FORMTEXT Preferred language of notices: FORMTEXT Are you interested in being involved in school group participation activities? (eg. School Council, excursions) (tick)

☐ Adult A ☐ Adult B ☐ Both ☐ Neither

PRIMARY FAMILY CONTACT DETAILS

ADULT A CONTACT DETAILS:Business Hours:

Can we contact Adult A at work? (tick)

☐ Yes ☐ No

Is Adult A usually home during business hours? (tick)

☐ Yes ☐ No

Work Telephone No: FORMTEXT

Other Work Contact information: FORMTEXT

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After Hours:Is Adult A usually home AFTER business hours? (tick)

☐ Yes ☐ No

Home Telephone No: FORMTEXT

Other After Hours Contact Information: FORMTEXT

Mobile No: FORMTEXT

SMS Notifications: ☐ Yes ☐ No

Adult A’s preferred method of contact: (tick one)(If Phone is selected, Email shall be used for communication that cannot be sent via phone.)

☐ Mail ☐ Email ☐ Phone ☐ Facsimile

Email address: FORMTEXT

Email Notifications: ☐ Yes ☐ No

Fax Number: FORMTEXT

ADULT B CONTACT DETAILS:Business Hours:

Can we contact Adult B at work? (tick)

☐ Yes ☐ No

Is Adult B usually home during business hours? (tick)

☐ Yes ☐ No

Work Telephone No: FORMTEXT

Other Work Contact information: FORMTEXT

After Hours:Is Adult B usually home AFTER business hours? (tick)

☐ Yes ☐ No

Home Telephone No: FORMTEXT

Other After Hours Contact Information: FORMTEXT

Mobile No: FORMTEXT

SMS Notifications: ☐ Yes ☐ No

Adult B’s preferred method of contact: (tick one)(If Phone is selected, Email shall be used for communication that cannot be sent via phone.)

☐ Mail ☐ Email ☐ Phone ☐ Facsimile


Email Notifications: ☐ Yes ☐ No

Fax Number: FORMTEXT

PRIMARY FAMILY DOCTOR DETAILS:

Doctor’s Name FORMTEXT Individual or Group Practice: (tick)

☐ Individual ☐ Group

No. & Street or PO Box No.: FORMTEXT

Suburb: FORMTEXT

State: FORMTEXT Postcode: FORMTEXT

Telephone Number FORMTEXT Fax Number FORMTEXT

Current Ambulance Subscription: (tick) ☐ Yes ☐ No Medicare Number: FORMTEXT

PRIMARY FAMILY EMERGENCY CONTACTS: (OTHER THAN PARENT/GUARDIAN)

Name Relationship Telephone Contact Language Spoken

(Neighbour, Relative, Friend or Other) (If English Write “E”)

1 FORMTEXT FORMTEXT FORMTEXT FORMTEXT


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PRIMARY FAMILY BILLING ADDRESS:Write “As Above” if the same as Family Home Address

No. & Street or PO Box FORMTEXT

Suburb: FORMTEXT


Billing Email ☐ Adult A ☐ Adult B

☐ Other (Please Specify)

OTHER PRIMARY FAMILY DETAILS

Relationship of Adult A to Student: (tick one)

☐ Parent ☐ Step-Parent ☐ Adoptive Parent☐ Foster Parent ☐ Host Family ☐ Relative☐ Friend ☐ Self ☐ Other

Relationship of Adult B to Student: (tick one)


The student lives with the Primary Family: (tick one)

☐ Always ☐ Mostly ☐ Balanced ☐ Occasionally ☐ Never

Send Correspondence addressed to: (tick one) ☐ Adult A ☐ Adult B ☐ Both Adults ☐ Neither

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DEMOGRAPHIC DETAILS OF STUDENT

In which country was the student born?

☐ Australia ☐ Other (please specify): FORMTEXT

Date of arrival in Australia OR Date of return to Australia: (dd-mm-yyyy)

What is the Residential Status of the student? (tick) ☐ Permanent ☐ Temporary

Basis of Australian Residency:

Eligible for Australian Passport ☐ Holds Australian Passport

Holds Permanent Residency Visa

Visa Sub Class: FORMTEXT Visa Expiry Date: (dd-mm-yyyy)Click or tap to enter a date.

Visa Statistical Code: (Required for some sub-classes) FORMTEXT

International Student ID :(Not required for exchange students) FORMTEXT

Does the student speak a language other than English at home? (tick) ( If more than one language is spoken at home, indicate the one that is spoken most often)

☐ No, English only ☐ Yes (please specify):

Does the student speak English? (tick) ☐ Yes ☐ No

Is the student of Aboriginal or Torres Strait Islander origin? (tick one)

☐ No ☐ Yes, Aboriginal

☐ Yes, Torres Strait Islander ☐ Yes, Both Aboriginal & Torres Strait Islander

What is the student’s living arrangements? (tick one):

☐ At home with TWO Parents/ Guardians ☐ State Arranged Out of Home Care # (See Note)

☐ At home with ONE Parent/ Guardian ☐ Homeless Youth

☐ Independent

# State Arranged Out of Home Care - Students who have been subject to protective intervention by the Department of Human Services and live in alternative care arrangements away from their parents. These DHS-facilitated care arrangements include living with relatives or friends (kith and kin), living with non-relative families (foster families or adolescent community placements) and living in residential care units with rostered care staff.

Student’s Travel:Beginning of journey to school: Map Type Melway / VicRoads / Country Fire Authority / Other

Map Number X Reference Y Reference

Usual mode of transport to school: (tick)

☐ Walking ☐ School Bus ☐ Train ☐ Driven ☐ Taxi

☐ Bicycle ☐ Public Bus ☐ Tram ☐ Self Driven ☐ Other

Student’s Religion: FORMTEXT

These questions are asked as a requirement of the Commonwealth Government. All schools across Australia are required to collect the same information.

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SCHOOL DETAILS

Date of first enrolment in an Australian School: Click or tap to enter a date.

Name of previous School: FORMTEXT

Years of previous education: What was the language of the student’s previous education? FORMTEXT

Does the student have a Victorian Student Number (VSN)?

☐ Yes.Please specify: FORMTEXT

☐ Yes, but the VSN is unknown ☐ No. The student has never been issued a VSN.

Years of interruption to education: Is the student repeating a year? (tick)

☐ Yes ☐ No

Will the student be attending this school full time? (tick) ☐ Yes ☐ No

If No, what will be the time fraction that the student will be attending this school? (i.e: 0.8 = 4 days/week)

Other school Name: FORMTEXT Time fraction: 0. Enrolled: ☐ Yes ☐ No

Other school Name: FORMTEXT Time fraction: 0. Enrolled: ☐ Yes ☐ No

CONDITIONAL ENROLMENT DETAILSIn some circumstances a child may be enrolled conditionally, particularly if the required enrolment documentation to determine the shared parental responsibility arrangements for a child is not provided. Please refer to the School Policy & Advisory Guide’s Admission page for more information (http://www.education.vic.gov.au/school/principals/spag/participation/Pages/admission.aspx).

Enrolment conditions

OFFICE USE ONLYHas the documentation been provided and retained on school records?

Yes No

Have the conditions been met to complete the enrolment? Yes No

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http://www.education.vic.gov.au/school/principals/spag/participation/Pages/admission.aspx

STUDENT ACCESS OR ACTIVITY RESTRICTIONS DETAILSIs the student at risk? ☐ Yes ☐ No

Is there an Access Alert for the student? (tick)

☐ Yes (If Yes, then complete the following questions and present a current copy of the document to the school.)

☐ No (If No, move to the immunisation / medical condition details questions.)

Access Type: (tick) ☐ Court Order ☐ Family Law Order ☐ Restraining Order ☐ Other

Describe any Access Restriction: FORMTEXT

Is there an Activity Alert for the student? (tick) ☐ Yes ☐ No

If Yes, then describe the Activity Restriction: FORMTEXT

OFFICE USE ONLY:Current custody document placed on student file? Yes No

STUDENT MEDICAL CONDITION DETAILS

Is there a Medical Alert for the student? (tick) ☐ Yes ☐ No

Does the student have a Disability ID Number? (tick) ☐ No ☐ Yes Disability ID No.:

Does the student suffer from any of the following impairments? (tick)

Hearing: ☐ Yes ☐ No Vision ☐ Yes ☐ NoSpeech: ☐ Yes ☐ No Mobility: ☐ Yes ☐ No

Does the student suffer from Asthma? (tick) If No, please go to the Other Medical Conditions section ☐ Yes ☐ No

ASTHMA MEDICAL CONDITION DETAILS:Answer the following questions ONLY if the student suffers from any asthma medical condition

Please indicate if the student suffers from any of the following symptoms: (tick)

If my child displays any of these symptoms please: (tick)

☐ Cough Inform Doctor ☐ Yes ☐ No☐ Difficulty Breathing Inform Emergency Contact ☐ Yes ☐ No☐ Wheeze Administer Medication ☐ Yes ☐ No☐ Exhibits symptoms after exertion Other Medical Action ☐ Yes ☐ No☐ Tight Chest If yes, please specify:

Has an Asthma Management Plan been provided to School? ☐ Yes ☐ No

Does the student take medication? (tick) ☐ Yes ☐ No Name of medication taken: FORMTEXT

Is the medication taken regularly by the student (preventive) or only in response to symptoms? (tick)

☐ Preventative ☐ Response

Indicate the usual dosage of medication taken: FORMTEXT Indicate how frequently

the medication is taken: FORMTEXT

Medication is usually administered by: (tick) ☐ Student ☐ Nurse ☐ Teacher ☐ Other

Medication is stored: (tick) ☐ with Student ☐ with Nurse ☐ Fridge in Staff Room ☐ Elsewhere

Dosage time Reminder required? (tick) ☐ Yes ☐ No Poison Rating

OTHER MEDICAL CONDITIONS(More copies of the other medical condition forms are available on request from the school.)


Does the student have any other medical condition? (tick) ☐ Yes ☐ No

If yes, please specify: FORMTEXT

Symptoms: FORMTEXT

If my child displays any of the symptoms above please: (tick)

Inform Doctor ☐ Yes ☐ No Inform Emergency Contact ☐ Yes ☐ NoAdminister Medication ☐ Yes ☐ No Other Medical Action ☐ Yes ☐ No

If yes, please specify: FORMTEXT

Does the student take medication? (tick) ☐ Yes ☐ No Name of medication taken: FORMTEXT

Is the medication taken regularly by the student (preventive) or only in response to symptoms? (tick)

Preventative Response

Indicate the usual dosage of medication taken:

Indicate how frequently the medication is taken:

FORMTEXT

Medication is usually administered by: (tick) ☐ Student ☐ Nurse☐ Teacher

☐ Other

Medication is stored: (tick) ☐ with Student ☐ with Nurse☐ Fridge in Staff Room

☐ Elsewhere

Dosage time Reminder required? (tick) ☐ Yes ☐ No Poison Rating

STUDENT DOCTOR DETAILSThe following details should only be provided if this student has a Doctor and/or Medicare number different to the Primary Family.

Doctor’s Name: FORMTEXT

Individual or Group Practice: (tick) ☐ Individual ☐ Group


Suburb: FORMTEXT

State: Postcode:

Telephone Number Fax Number

Student Medicare Number:

STUDENT EMERGENCY CONTACTSThis section should ONLY be filled out if THIS student has emergency contacts other than the Prime Family Emergency Contacts.

Name Relationship Language Spoken Telephone Contact(Neighbour, Relative, Friend or Other) (If English Write “E”)



In the event of illness or injury to my child whilst at school, on an excursion, or travelling to or from school; I authorise the Principal or teacher-in-charge of my child, where the Principal or teacher-in-charge is unable to contact me, or it is otherwise impracticable to contact me to: (cross out any unacceptable statement)

consent to my child receiving such medical or surgical attention as may be deemed necessary by a medical practitioner,


administer such first aid as the Principal or staff member may judge to be reasonably necessary.

I/We certify that the information contained in this form is correct.

Signature of Adult A: Signature of Adult B:

Date: Click or tap to enter a date.

Thank you for taking the time to complete this Student Enrolment form. We understand that the information you have provided is confidential and will be treated as such, but the details are required to enable staff to properly enrol your child at our school.


If your child lives some of the time with the other Parent or another family member, please fill in the details below.

ALTERNATIVE FAMILY DETAILS

ADULT A OF ALTERNATIVE FAMILY DETAILS:


Title: (Ms, Mrs, Mr, Dr etc) FORMTEXT



What is Adult A’s occupation? FORMTEXT

Who is Adult A’s employer? FORMTEXT

In which country was Adult A born?


Does Adult A speak a language other than English at home? (If more than one language is spoken at home, indicate the one that is spoken most often.) (tick)☐ No, English only☐ Yes (please specify):

Please indicate any additional languages spoken by Adult A: FORMTEXT


What is the highest year of primary or secondary school Adult A has completed? (tick one) (For persons who have never attended school, mark ‘Year 9 or equivalent or below’.)☐ Year 12 or equivalent☐ Year 11 or equivalent☐ Year 10 or equivalent☐ Year 9 or equivalent or below

What is the level of the highest qualification the Adult A has completed? (tick one)

☐ Bachelor degree or above☐ Advanced diploma / Diploma☐ Certificate I to IV (including trade certificate)☐ No non-school qualification

What is the occupation group of Adult A? Please select the appropriate parental occupation group from the attached list. If the person is not currently in paid work but has had a job in



ADULT B OF ALTERNATIVE FAMILY DETAILS:



Title: (Ms, Mrs, Mr, Dr etc) FORMTEXT



What is Adult B’s occupation? FORMTEXT

Who is Adult B’s employer? FORMTEXT

In which country was Adult B born?


Does Adult B speak a language other than English at home? (If more than one language is spoken at home, indicate the one that is spoken most often.) (tick)☐ No, English only☐ Yes (please specify):

Please indicate any additional languages spoken by Adult B: FORMTEXT


What is the highest year of primary or secondary school Adult B has completed? (tick one) (For persons who have never attended school, mark ‘Year 9 or equivalent or below’.)☐ Year 12 or equivalent☐ Year 11 or equivalent☐ Year 10 or equivalent☐ Year 9 or equivalent or below

What is the level of the highest qualification the Adult B has completed? (tick one)☐ Bachelor degree or above☐ Advanced diploma / Diploma☐ Certificate I to IV (including trade certificate)☐ No non-school qualification

What is the occupation group of Adult B? Please select the appropriate parental occupation group from the attached list. If the person is not currently in paid work but has had a job in



These questions are asked as a requirement of the Commonwealth Government. All schools across Australia are required to collect the same information

Main language spoken at home: FORMTEXT Preferred language of notices: FORMTEXT

Are you interested in being involved in school group participation activities? (eg. School Council, excursions) (tick)

☐ Adult A ☐ Adult B ☐ Both ☐ Neither


ALTERNATIVE FAMILY CONTACT DETAILS

ADULT A OF ALTERNATIVE FAMILY CONTACT DETAILS:

Business Hours:Can we contact Adult A at work? (tick)

☐ Yes ☐ No

Is Adult A usually home during business hours? (tick)

☐ Yes ☐ No

Work Telephone No:

Other Work Contact information:

After Hours:Is Adult A usually home AFTER business hours? (tick)

☐ Yes ☐ No

Home Telephone No:

Other After Hours Contact Information:

Adult A’s preferred method of contact: (tick one)

☐ Mail ☐ Email ☐ Facsimile


Fax Number:

ADULT B OF ALTERNATIVE FAMILY CONTACT DETAILS:

Business Hours:Can we contact Adult B at work? (tick)

☐ Yes ☐ No

Is Adult B usually home during business hours? (tick)

☐ Yes ☐ No

Work Telephone No:

Other Work Contact information:

After Hours:Is Adult B usually home AFTER business hours? (tick)

☐ Yes ☐ No

Home Telephone No:

Other After Hours Contact Information:

Adult B’s preferred method of contact: (tick one)

☐ Mail ☐ Email ☐ Facsimile


Fax Number:

ALTERNATIVE FAMILY HOME ADDRESS:No. & Street: or Box details Click or tap here to enter text.

Suburb: Click or tap here to enter text.

State: Postcode:

Telephone Number Silent Number: (tick) ☐ Yes ☐ No

Mobile Number: Fax Number:

ALTERNATIVE FAMILY MAILING ADDRESS:Write “As Above” if the same as Family Home Address

No. & Street FORMTEXT

Suburb: FORMTEXT

State: Postcode:


ALTERNATIVE FAMILY DOCTOR DETAILS:Doctor’s Name FORMTEXT Individual or Group Practice:

(tick)☐ Individual ☐ Group


Suburb: FORMTEXT


Telephone Number FORMTEXT Fax Number FORMTEXT

Current Ambulance Subscription: (tick) ☐ Yes ☐ No Medicare Number: FORMTEXT

ALTERNATIVE FAMILY EMERGENCY CONTACTS:Name Relationship Telephone Contact Language Spoken

(Neighbour, Relative, Friend or Other) (If English Write “E”)




OTHER ALTERNATIVE FAMILY DETAILS

Relationship of Adult A of Alternative Family to Student: (tick one)


Relationship of Adult B of Alternative Family to Student: (tick one)


The student lives with the Alternative Family: (tick one)

☐ Always ☐ Mostly ☐ Balanced ☐ Occasionally ☐ Never

Send Correspondence addressed to: (tick one) ☐ Adult A ☐ Adult B ☐ Both Adults ☐ Neither

Is the Alternative Family to receive Academic Reports? ☐ Yes ☐ No

Thank you for taking the time to complete this Student Enrolment Form. We understand that the information you have provided is confidential and will be treated as such, but the details are required to enable staff to properly enrol your child at our school.

I/We certify that the information contained within this form is correct.

Adult A Signature: Adult B Signature:

Date: Click or tap to enter a date.


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